News from ASCO 2011

Each year nearly 30,000 oncologists and
oncology-related healthcare professionals
come together at the annual meeting of the
American Society of Clinical Oncology (ASCO).
ASCO 2011 featured nearly 4,500 abstracts
(research summaries) and sessions covering
every aspect of cancer, including highly
anticipated research news and drug studies
that could change current standards of care
for patients. Attendees include a few hundred
patient advocates who represent their constituents
in the cancer community. I was fortunate
to take part in the Focus on Research program
of the Research Advocacy Network's Advocate
Institute.

Hereditary Cancer

A study specifically related to BRCA (Abstract
1512) suggested that women with DCIS and a
family history of breast and/or ovarian cancer
have an increased chance of having BRCA
mutations regardless of age, and should consider
genetic counseling and testing even
though they do not have invasive cancer.
Another study (Abstract 1517) showed that
BRCA-positive men are more likely to have
aggressive prostate cancer with lymph node
involvement and metastases.
These study results underscore
the importance of
knowing BRCA status when
determining treatment.

Hormone replacement therapy
(HRT) by women who
have undergone a prophylactic oophorectomy
is of great interest to the HBOC community.
Promising news from the Prevention and
Observation of Surgical Endpoints (PROSE)
study indicated no increased risk of breast
cancer risk when HRT is used after risk-reducing
salpingo-oophorectomy (Abstract 1501).
Another study (Abstract 1510) suggested that
women with paternally-inherited BRCA gene
mutations (mutation passed from the father)
are diagnosed with cancers at earlier ages
compared to women who inherit gene mutations
from their mothers.

Ovarian Cancer

Researchers presented promising findings
from the OCEANS (Abstract LBA5007) and
ICON7 (Abstract LBA5006) trials, two studies
that examined use of the drug bevacizumab
(Avastin) to treat ovarian cancer. While overall
survival benefits were not indicated, patients in these studies did experience improved
progression-free survival. The concept of
progression-free survival (PFS) compared to
overall survival (OS) were common themes
throughout the conference. PFS refers to the
chance of stabilizing a disease without further
progression after a particular treatment. OS
measures the specific length of survival after
treatment. Scientists use these terms to measure
the success or efficacy of new cancer
therapies. There is great debate about whether
or not a drug should be approved if it doesn't
demonstrate OS benefits. For patients facing
advanced disease, PFS may seem like an acceptable
endpoint.

Quality-of-Life

A number of ASCO meeting sessions focused
on quality-of-life issues. One abstract described
the development of a standard method
for including patient-reported outcomes in
oncology drug clinical trials that compare drug
effectiveness. Additional studies focused on
developing tools to foster enhanced physicianpatient
interaction. Researchers reported that
early palliative care (care or treatment that
concentrates on reducing the severity of symptoms)
results in increased overall survival and
reduced depression. A session on Assessing
Patients' Psychosocial Needs? highlighted an
area needing improvement by many medical
professionals; at least a quarter of cancer
patients are thought to experience significant
depression or anxiety.

A Weighty Issue

Numerous studies have looked at the issue of
lifestyle, weight or Body Mass Index (BMI) in
relation to cancer — especially breast, prostate
and colorectal cancer. The 'Overview of the
Current Evidence Supporting Body Weight
Status, Adiposity, and Weight Loss on Cancer
Outcomes' session explained that obese and
overweight people are more likely to develop
and die from cancer and have an increase in
risk of recurrence. Presenters made a provocative
point: Overweight patients often receive
the same level of chemotherapy as leaner individuals, and may in fact be underdosed,
which leads to poorer treatment response
rates. The good news is that most people can
improve their treatment outcomes by modifying
their lifestyle (Abstract 167); research indicates
that individuals who lose weight experience
a decreased risk of cancer recurrence.

Throughout the meeting, I was struck by the
fact that genetics was a topic of numerous
sessions and studies. Many researchers are
focusing their efforts on identifying biomarkers
and genetic changes in cancer tumors. This
evolving area of science, in which genetics
is linked to cancer biology, is very promising.

Improvements in gene sequencing and targeted
therapies will ultimately help guide
cancer treatment and move us toward more
personalized medicine — the goal is for doctors
to know exactly what treatments to give which
patients — resulting in better outcomes. That is
certainly something to strive for. Access the
abstracts at the ASCO website (www.asco.org).

Lisa Schlager is Vice President of Community
Affairs & Public Policy for FORCE. A BRCA1 previvor,
she lives in the DC area with her husband
and 2 children.

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